Ever had a physician ask you to rate your pain on a scale from one to ten? It's an odd question, and one I can only answer with a guess. Pain is immediate, yet once it's gone it's like it never happened. You forget about it, sure you can remember the suffering but the pain? Here's an example - I once stepped on a sea urchin, a spine went deep into my foot, it was quite painful. Well it was until my foot was submerged in hot water. Then the pain was gone. Over and done. Turned off like a light switch. And that's my primary memory of the incident, a near instant relief from pain. On a scale of one to ten how bad did it hurt? I'd hafta to say "yes" How do you rate pain? What's worse a skinned knee or a fat lip? How about a broken bone versus a severe sunburn? Hangover or passing a kidney stone? Here's a woman who claims Hallux Rigidus is worse than giving birth. How would you sort your injuries by pain?
I think it's bullshit because pain is surely subjective to interpretation, mental recognition, state of mental health (such as whether or not there is depression magnifying one's concentration on pain/illness) and prior experience. If it were the same for everyone I dare say there would not be people who were hypochondriacs, and people who were able to soldier on to work with the toughest cancers.
probably easier than the subjectivity of adjectives Could you imagine if the doctor sounded liek a survey questionnaire? Is your pain: 1) Highly Bearable 2)Somewhat Bearable 3)Somewhat Unbearable 4)Highly Unbearable 5)There are bears?
Unfortunately it is something that the medical and nursing staff are required to ask. Here's how I usually ask the person about pain: on a scale of 1 to 10 with 1 being a gnat landing on you and 10 an elephant, how do you rate the pain? We know pain is subjective; however we want to give the correct amount of medicine to relieve the pain without over sedating the person. Thus a person with a pain level of 4 would get the less potent medicine than a pain level of 10. (and thus druggies always have a pain level of 10 even if they were just cavorting around the unit without a flinch 5 seconds before)
confused by this. do you mean you automatically just whack 'em with a maximum dosage presuming tolerance or that they're drama queens that have to hold their own needle or else they faint?
Actually what I meant is that folks who manage to get admitted so they can get drugs always say their pain is 10out of 10. There are other indicators that show pain: grimacing, elevated heart rate and/or blood pressure etc. If I'm still unclear, I'll try to clarify better once I get home. Trying to type on iPod isn't easiest thing in the world for me
They asked me that question when I was admitted to emergency with a kidney stone. I couldn't answer because I was doubled over in pain and about to pass out. I think the hospital staff figured it out on their own. Ah, sweet sweet morphine.
They ask the question and then frequently disregard it - someone who says too small a number is assumed trying to be a tough guy and someone who says too high a number is a druggie.
It's not. Back in the 1990's, the WoD started causing the shift in drug use from pot, etc., to prescription narcotics and it got to the point that you could be screaming in pain, but the docs would under-treat it. The medical community saw that and started forcing the docs to address pain, and the pain scale was part of that. I got caught up in that. I was in that car wreck back in 1991 that blew out a disc at the base of my spine. I had to have spinal surgery to remove the fragments and what little was left of the disc. My pain was definitely a 10 for several months, but trying to get a little pain medication was like pulling teeth. I walked the floors every night all night long until I would finally go to sleep out of fatigue and exhaustion, and maybe sleep a couple of hours until the pain woke me back up. The irony of the time was that the druggies seemed to be able to get all the narcotics they wanted, but patients who were legitimately in pain were left out in the cold.
In conjunction with a good history and a set of notes it's a very swift way of identifying the severity of an ailment, and for me helps me deal with little old Indian women complaining of "total body pain" in a timely manner.
Especially when you're also driving in heavy traffic, drinking coffee, and trying to find your way by looking out at the stars, all at the same time!
That could actually be more practical than a generic 1-10 scale, as it's based off something that can be estimated: The length of time you think you can wait for relief before dissolving into a puddle of tears and pain. Anyway, here is another pain scale for consideration.
I agree with the subjectivity part. When my appendix was about to burst in 1997 and I was waiting on the OR in Texarkana (never have emergency surgery on a Saturday night) I was lying on a hospital bed and talking to two of my sisters who made it to see me. A spasm of pain would hit about once every five minutes and hurt intensely for about 10 seconds then be gone and I would resume talking to them.
Not really. When we see someone grabbing the side rails in a death grip, gritting their teeth when they talk but say their pain is only a 1 or 2 out of ten, we kind of think they are afraid of taking the stronger medication that is ordered for them. Those are the kind who are "afraid of getting hooked on medication." Then we have to go through a whole section of pain medication teaching. When we see certain folks back again and again with the same "complaint" and demanding the strongest medication because "nothing else works," THAT'S when we start to say "druggie."
Ramsay Hunt syndrome. It's shingles on your face and in your mouth. NEVER have I experienced such pain. The doctors asked me the one-to-ten-scale question. I screamed ELEVEN!!!!!!!! I got some nice vicodin out of it.
How old were you when you had Shingles? I had them when I was very young and the doctor (actually three when a couple more were asked to look) said he had never seen a case in a child my age. Reminds me of a joke though. A man comes into the doctors office. He stands waiting for 45 minutes before the receptionist says "What do you have". He says "Shingles". So she hands him six pages to fill out about his insurance, vital statistics, and person responsible for payment and to make life decisions if he is unable. Then a nurse comes and leads him back to an exam room. After sitting there for 50 minutes the nurse comes back and says "What do you have". The man says "Shingles". The nurse tells the man to take off his clothes, takes down his medical history and tells him to wait for the doctor. After an hour, the doctor comes in and says "What do you have?". The man says "Shingles". The doctor says "Where?" The man says "Out on the truck. Where do you want them?"
I've had two bouts with kidney stones. I often say that the first one was, up til then, the most painful experience of my life. The second one made the first one seem pleasant. For that second one, I was laying on a gurney in the emergency room, writhing in pain, moaning like the damned, and, generally, not giving a shit who might've been bothered by that. Once the doctor made the diagnosis, he sent me a nurse with some morphine derivative. She injected me and it turned the pain off so quickly, that it was frightening. I felt, for a moment, like a computer being shut down. After I recovered from the surprise and the euphoria started to hit me, I looked at the nurse and said "Ooooh, that's some good stuff." And she was like "I know, right?"
There needs to be an understanding of the subjective nature of pain, and on that basis the sufferer should be asked to describe it in subjective terms. Responses could range from, "Well, it's really gettin' old" to "if I could get away with it, I'd chokeslam a puppy into a wood chipper" to "AAAAAAAAAAAAAAAAAAAAAAAAAAAA!!!"
For a moment I thought the thread title had something to do with the I-10, which is universally believed to be a pain. Clearly I've been in LA too long... The 1-10 scale is a good beginning because, yes, pain is subjective, but being asked the question makes you stop and think. And perceptive medical personnel can watch your body language as you're weighing the question and assess whether you're in real distress or just looking to score. If they actually have the time (i.e., it's not Saturday night or the 4th of July), they can ask a follow-up question. "Can you describe it?" or "What does it feel like?" Answers like "a spike driven through my upper jaw into my brain" or "a hedgehog rolling around in the lower left quadrant" can be helpful.
I get it all the time. So far the worst pain I've endured were 2 incidents...once when my coumadin went way out of whack to the point that my blood was essentially not really clotting properly at all...I ended up urinating blood and having a spontaneous stomach bleed. They thought it was a kidney stone before the PT/INR came back..I was sent home just to be frantically called to rush to the ER. That was the first time I ever had Morphine and it's ability to relieve pain was awesome. The second time was a round of gout so bad it was in a foot, my knee and worst of all, my hand and wrist. A literal breeze across my hand made me scream. All morphine did was reduce the pain, not eliminate it. That was and still is the worst I've ever had and that includes many recoveries from surgeries. I had a cut from armpit to elbow that was nothing next to that gout. I hate pain.
Had gout bad enough the pain traveled up to the knee, and I seriously contemplated chopping my leg off. ....then I had a kidney stone, and dearly wished for the gout back in its place. Those are MY 9 and 10, but, I haven't had my skin burned off, so.... Chup is right, it's subjective.
Used to be the worst pain I'd ever experienced was getting a bad tooth yanked when I was young. But a couple years ago I tore the meniscus in my right knee and that was real pain. Until the percoset. Oh my.
I've heard horror stories about the pain of having/passing a kidney stone. And have seen the scars from how kidney stones used to be treated - A scar that well could have been made by a machete nearly bisecting a torso. Right?! Just like that the pain is gone. Over and done. just like turning off like a light switch. Almost like the pain was never there.
Owww! Closest I've come is when my left knee swelled up with a boil on top. The slightest contact was unbearable, pants were simply out of the question. The pain really kicked in when my doctor decided to lance the boil with the equivalent of an X-Acto knife. Yep, she plunged right into the center of boil and proceeded to pull, tear and rip it open. Yeah it was rather horrific. But the worst was yet to come. To drain the swelling she used a needle-less syringe. Repeatedly jamming it into an unbelievably tender area trying to suck out all the pus. She was quite thorough. I remember gripping the chair tightly, my mouth sweating and an odd taste of metal. Then it was over, swelling gone, bandage attached and I was on my way. Most of the time I consider pain like a fire alarm, a heads up that something is wrong. Yet like a fire alarm it doesn't always take a fire to set it off. Realizing the difference goes a long way in managing the pain and making it hurt a lot less.
